IOM DHSC & MANX CARE

[Two-lane]

1 hour ago, Apple said:

Apart from the obvious issue the tone and style of this says a lot about the attitudes behind and driving Manx Care. See what you think.

"We must take complaints very, very seriously. They are a *great* opportunity for us to learn and improve the services."

They need to learn? If she was running a restaurant she is the kind of person who needs the customers to complain before realising she has to to improve the dire food and service?

[Apple]

58 minutes ago, Two-lane said:

If she was running a restaurant she is the kind of person who needs the customers to complain before realising she has to to improve the dire food and service?

Best not listen to last weeks Manx radio show as it seemed to consist of a  lot of - 'I'll look into that when I get back to the office" type comments. 
I agree - it is now the best way to assess the state of the service. We have known the complaints process is broken and has been since Bill Shimmins MHK declared it it HoK two years ago.. Nice to see them catching up.

I hear Manx Care do not take kindly to politicians commenting on issues they no longer should be involved in., and Manx Care has sent them all a handy 'help us to help you" guide which I suppose helps them keep them on the er.. straight and narrow. 

[Two-lane]

3 minutes ago, Apple said:

I hear Manx Care do not take kindly to politicians commenting on issues they no longer should be involved in

That is a puzzling statement. Which issues are MHKs not permitted to comment on?

[John Wright]

31 minutes ago, Two-lane said:

That is a puzzling statement. Which issues are MHKs not permitted to comment on?

Ranson, is the primary example.

There is a new Health & Care Complaints Ombudsman body to start soon. Function based very much on the Financial Service Ombudsman. Not fault of Manx Care it’s taken so long.  Tynwald took until late 2021 to pass the primary legislation. Then it’s taken forever to get secondary legislation. That’s down to AG and DHSC ( as sponsoring Dept ).

The Senior Adjudicator/Ombudsman has been appointed. The old Health Services Independent Review Body is being disbanded. Members of the new Ombudsman scheme will be advertised for,  shortly.

I was speaking with the Ombudsman designate. I joined the HS IRB in 2021. It was the most incompetent and unfit for purpose public body I’ve ever sat on. More concerned with irrelevance, procedure  and obstacles, and with no focus on resolving complaints it received. 

I upset the longest serving “convenor”, and the “secretary” and was ghosted. They tried to get Magson to discipline me. She had no concept that the word independent meant she couldn’t.

I resigned earlier this year. It was pointless trying to carry on. The chair and secretary wouldn’t communicate. Meeting were cancelled, I was not notified. A new ( temporary ) secretary was appointed but I wasn’t told. We had no meetings for 9 months.

Last year I made substantial contributions to the Consultation on the replacement for the IRB, including basic principles, structure and a draft, plain English, operating guidelines for use by adjudicators, complainants, investigators, and service providers alike.

[Jarndyce]

1 hour ago, John Wright said:

I was speaking with the Ombudsman designate

John, notwithstanding that the new body doesn’t exist yet: what’s your personal level of confidence that it will be able (or be allowed) to fulfil its remit more effectively than the old IRB?

[cissolt]

Sorry to hear that John, they dont like this independent person malarkey!

[John Wright]

8 hours ago, Jarndyce said:

John, notwithstanding that the new body doesn’t exist yet: what’s your personal level of confidence that it will be able (or be allowed) to fulfil its remit more effectively than the old IRB?

The financial services ombudsman scheme works well. In my opinion. I would say that, I’m the senior adjudicator.

A lot will depend on the new senior health & care ombudsman and his team. They have the opportunity to make it work.

The big problem with any ombudsman scheme is that it depends on the parties to behave sensibly.

That means attempting local  ( internal by the hospital, GP, dentist, care home ) resolution first. The service provider not being defensive, openness and transparency, actually identifying complaints and dealing with them and producing documents swiftly..

In the few cases I dealt with there was evidence of failure to identify a complaint as such and investigate and delayed document production.

That also happens in financial services.

My solution is to fix a timetable and say, from early on, that the investigation will take place with missing documents. But, where documents are missing that’s likely to give rise to adverse inferences and full acceptance of the complainants case where it isn’t contradicted by documents that haven’t been produced.

[Jarndyce]

4 hours ago, John Wright said:

The big problem with any ombudsman scheme is that it depends on the parties to behave sensibly (…), the service provider not being defensive,

Thanks for the detailed response and, as a resident and a patient, I sincerely hope that a change for the better is on the horizon.   However, I suspect the problem identified by you (and quoted by me above) will be the stumbling block.

In the past, DHSC’s default stance to any complaint has been “defensive” and all the other poor behaviours (lack of transparency, unwillingness to accept the complaint, attempts to undermine the complainant, etc) have flowed from that fundamental attitude.  

“Lessons will be learned” is only satire because no-one believes that IOMG have any interest in learning from errors - hence they are doomed to repeat past mistakes.   If Manx Care could only move from “How do we fight this complaint ” to “How do we learn from this complaint”…but that would be a huge culture change.

Listening to Ms Cope and (particularly) “Clinical Governance Czar” Mr Moore on the radio does not give much encouragement that anything at all will change in the brave new world of Manx Care.

Edited November 8, 2022 by Jarndyce
Addition for clarity

[Banker]

I must say that the recent initiatives to bring additional resources from UK to clear backlogs has been a good success with 2 elderly relatives getting cataract operations & a friend having knee operation after waiting a few years on lists 

[Jarndyce]

9 minutes ago, Banker said:

I must say that the recent initiatives to bring additional resources from UK to clear backlogs has been a good success

I wouldn’t disagree - credit where credit’s due and all that.

[Andy Onchan]

On 11/6/2022 at 7:57 PM, wrighty said:

I’d love it if we had a proper, integrated electronic patient record, which has facilities to send secure messages to GPs and the patients themselves. Voice recognition for note entry, check, click and send to GP and patient immediately after It’s dictated/typed. 
 

But we don’t, and we’re not going to. I tried. 
 

In any case a majority of our patients don’t do email - it’s alright for you and me, but not the average octogenarian who comes to clinic. 
 

So, any solutions to the current problem @BriT, or just going to keep pointing out that it shouldn’t be like this?

Just because you tried and it didn't work doesn't mean that it can't work, shirley? Elderly patients shouldn't be used as an excuse for not streamlining the system (actually I think you'd be surprised how many of the older generation actually do use smart phones/devices of for no other reason than to keep in touch with family). Think big picture.

Is it all down to funding? Or some other reason?

[Apple]

2 hours ago, Banker said:

I must say that the recent initiatives to bring additional resources from UK to clear backlogs has been a good success with 2 elderly relatives getting cataract operations & a friend having knee operation after waiting a few years on lists 

Agreed. I met Mr Baird last week and I was very impressed. I hear nothing but good things about his team and his work here.

 

1 hour ago, Andy Onchan said:

Just because you tried and it didn't work doesn't mean that it can't work,

Re the patient records system. There have been several attempts over the years to solve this issue. An all island record would cost an absolute fortune.

The danger is that we now have a double system, a combination of paper (or alternative) and several IT systems. Therefore communication problems will continue. The gaps in information between sources and recipients worries me.

Edited November 8, 2022 by Apple
typos

[Apple]

16 hours ago, Two-lane said:

Which issues are MHKs not permitted to comment on?

I couldn't possibly comment but why not ask your MHK.😀

[Andy Onchan]

17 minutes ago, Apple said:

Agreed. I met Mr Baird last week and I was very impressed. I hear nothing but good things about his team and his work here.

 

Re the patient records system. There have been several attempts over the years to solve this issue. An all island record would cost an absolute fortune.

The danger is that we now have a double system, a combination of paper (or alternative) and several IT systems. Therefore communication problems will continue. The gaps in information between sources and recipients worries me.

With a population the size of 85K a unified single system really shouldn't be an issue, nor an excuse. I'm not convinced that the cost is prohibitive if it's taken in context with the issues that currently exist. I dread to think what's going to happen if and when the population gets to +100K (if that's what our politicians & Cyril's Servants think should happen.

We don't have joined up government because we don't have joined up thinking. 

[Boo Gay'n]

46 minutes ago, Apple said:

I couldn't possibly comment but why not ask your MHK.😀

As you know, we have developed a rather weird extra-parliamentary system of members' briefings which are not on public record.  Because of that, the voting public cannot be sure what business is actually being conducted inside the hallowed walls of the wedding cake.  It may be that Alf, ministers, Attorneys General or even senior civil servants use those sessions to ask members not to talk publicly about subject A or subject B.  We will never know.  I also worry a bit about WhatsApp/Telegram (etc.) groups and what is discussed in them - for the same reasons.  As for members using parallel email systsms such as Gmail (à la Sweet Suella), I'm sure that could never happen here...